Factors associated with severe postoperative pain in patients with total hip arthroplasty

Petrovic, Nadezda M; Milovanovic, Dragan R.; Ignjatovic-Ristic, Dragana; Riznić, Nikola; Ristić, Branko; Stepanović, Željko

doi:10.3944/aott.2014.14.0177

Cited by 42 publications

(38 citation statements)

References 38 publications

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“…These factors are enhanced in healthy women and are relevant for acute as well as chronic pain after surgery [1]. Recent studies further confirm these observations [94,95 & ] and stress the importance of psychological factors in postoperative pain [26,[96][97][98]. Thus, psychological factors might be the actual contributors to increased pain, both acute and chronic, after surgery rather than female gender.…”

Section: Possible Confounders For Gender Differencesmentioning

confidence: 63%

“…With regard to gender aspects, recent studies on patients submitted to hip or knee arthroplasty yielded inconsistent results. In one study (n ¼ 90), female gender (OR ¼ 4.9), as well as anxiety (OR ¼ 6.0) and depression (OR ¼ 7.3), among other factors, were highly associated with severe acute postoperative pain after total hip arthroplasty [26]. In another study (n ¼ 102), women showed a longer duration of postoperative pain within the first 6 weeks after open or arthroscopic rotator cuff repair (33 vs. 26 days in men, P ¼ 0.03), but prevalence of residual pain did not significantly differ (62 vs. 41%, P ¼ 0.11) [27].…”

Section: Orthopedic Surgerymentioning

confidence: 97%

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Gender aspects in postoperative pain

Pereira

Pogatzki-Zahn

2015

Current Opinion in Anaesthesiology

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Section: Possible Confounders For Gender Differencesmentioning

confidence: 63%

Section: Orthopedic Surgerymentioning

confidence: 97%

Gender aspects in postoperative pain

Pereira

Pogatzki-Zahn

2015

Current Opinion in Anaesthesiology

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“…Even though depressive symptoms predict worse pain scores in most surgical populations, the target domains are usually activity interference and pain severity, but not perception of care. 28,29 The findings point out important differences in pain perception between surgical populations that need consideration when measuring the outcomes of new care plans.…”

Section: Discussionmentioning

confidence: 96%

Early Postoperative Pain and its Predictors in the Adult to Adult Living Donor Liver Transplantation Cohort Study

et al. 2016

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Background Little is known about how well postoperative pain is managed in living liver donors, despite pain severity being the strongest predictor of persistent pain with long-lasting disability. Methods We conducted a prospective multicenter study of 172 living liver donors. Self-reported outcomes for pain severity, activity interference, affective (emotional) reactions, adverse effects to treatment, and perceptions of care were collected using the American Pain Society Patient Outcomes Questionnaire-Revised. Mixed effects linear regression was used to identify demographic and psychosocial predictors of subscale scores. Results Donors were young (36.8±10.6) and healthy. Of 12 expert society analgesic recommendations for postoperative pain management, 49% received care conforming to 3 guidelines, and only 9% to 4 or 5. More than half reported adverse effects to analgesic treatment for moderate to severe pain that interfered with functional activity; however, emotional distress to pain was unexpectedly minimal. Female donors had higher affective (Beta=0.88, p=0.005) and adverse effects scores (Beta=1.33, p<0.001). Donors with 2 or more medical concerns prior to surgery averaged 1 unit higher pain severity, functional interference, adverse effects, and affective reaction subscale scores (Beta range 1.06–1.55, all p<0.05). Receiving information about pain treatment options increased perception of care subscale scores (Beta=1.24, p=0.001), while depressive symptoms before donation were associated with lower scores (Beta=-1.58, p=0.01). Conclusions Donors have a distinct profile of pain reporting that is highly influenced by psychological characteristics. Interventions to improve pain control should consider modifying donor behavioral characteristics in addition to optimizing pain care protocols.

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“…It has been shown to adversely affect the postoperative pain and bring enormous suffering to patients [6][7][8][9]. Although increasing clinical evidence has demonstrated the positive correlation between anxiety and pain during the perioperative period [5,7], few laboratory studies were conducted to investigate this phenomenon.…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative anxiety is very common in patients undergoing surgery, with an incidence of 60 to 92 % [2,4,5]. Many studies have shown the positive correlation between preoperative anxiety and postoperative pain intensity as well as analgesic consumption [5][6][7][8][9]. The phenomenon that exposure to physical or psychological stressors can enhance nociception and pain sensitivity is described as stress-induced hyperalgesia (SIH) [10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Glucocorticoid-Potentiated Spinal Microglia Activation Contributes to Preoperative Anxiety-Induced Postoperative Hyperalgesia

et al. 2016

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Clinically, preoperative anxiety adversely affected postoperative hyperalgesia. As stress-induced glucocorticoids (GCs) were reported to sensitize the activation of microglia, the present study investigated whether and how GCs and microglia played in the process of preoperative anxiety-induced postoperative hyperalgesia. The study used an animal model that exposed rats to single prolonged stress (SPS) procedure to induce preoperative anxiety-like behaviors 24 h before the plantar incisional surgery. Behavioral testing revealed that preoperative SPS enhanced the mechanical allodynia induced by plantar incision. SPS was also found to induce elevated circulating corticosterone levels, potentiate the activation of spinal microglia, and increase the expression of spinal proinflammatory cytokines. Inhibition of microglia by pretreatment with minocycline attenuated the SPS-enhanced mechanical allodynia, and this was accompanied by decreased activation of spinal microglia and expression of proinflammatory cytokines. Another experiment was conducted by administering RU486, the GC receptor (GR) antagonist, to rats. The results showed that RU486 suppressed SPS-induced and SPS-potentiated proinflammatory activation of spinal microglia and revealed analgesic effects. Together, these data indicated that inhibition of stress-induced GR activation attenuated the preoperative anxiety-induced exacerbation of postoperative pain, and the suppression of spinal microglia activation may underlie this anti-hyperalgesia effect. Pending further studies, these findings suggested that GR and spinal microglia may play important roles in the development of preoperative anxiety-induced postoperative hyperalgesia and may serve as novel targets to prevent this phenomenon.

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Factors associated with severe postoperative pain in patients with total hip arthroplasty

Abstract: Patients with severe anxiety, depression and Type D personality appear to be at risk of developing severe postoperative pain. In addition, female gender and the intensity of pain immediately after procedure were found to be important risk factors.

Cited by 42 publications

References 38 publications

Gender aspects in postoperative pain

Gender aspects in postoperative pain

Early Postoperative Pain and its Predictors in the Adult to Adult Living Donor Liver Transplantation Cohort Study

Glucocorticoid-Potentiated Spinal Microglia Activation Contributes to Preoperative Anxiety-Induced Postoperative Hyperalgesia

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